An implant is insertable in the joint space to separate bones of the joint. The implant has two endplates each configured to engage a separate articulating bone of the joint, and a threaded member positioned between the two endplates and configured to increase the space between the two endplates when the threaded member is rotated. A rotatable gear is engaged with the threaded member, and is engageable with a rotating gear of a connected implantation tool, so that rotation of the gear on the tool causes rotation of the threaded member and expansion of the implant to separate the bones. Connector portions on the tool and the implant may be rotated together to securely engage the implant and the tool so that the gears of the tool and the implant can be rotated using an actuator outside of the body, when the implant is inside the body.

A joint spacer has first and second endplates, with each having a bone engaging surface, and at least two cams with an inclined cam surface positioned on an opposite side. First and second slides, each having ramps with an inclined surface are engaged with the cams of the endplate. The first slide has an angled portion at an end, and the second slide has a hinge portion. A threaded shaft has a hinge portion connected to the slide hinge portion, connecting the shaft to the slide, enabling the shaft to pivot. A nut is threaded to the shaft, and can contact and interfere with the angled portion of the first slide to drive the first slide with respect to the second slide. This results in engagement of the cams and ramps to drive the endplates apart to increase the spacer height.

An expandable interbody fusion implant device has a frame, two ramp assemblies and two overlying base plates driven by two independent drive shafts. The two ramp assemblies include a distal ramp assembly and a proximal ramp assembly. Each ramp assembly has a translating ramp, a first pivoting hinged ramp and a second pivoting hinged ramp. The two overlying base plates include a first base plate overlying a second base plate. Each base plate is hinged to the distal ramp assembly and the proximal ramp assembly at an end of one of said pivoting hinged ramps of each ramp assembly. The two independently driven drive shafts include a first drive shaft for translating the distal ramp assembly and a second drive shaft for translating the proximal ramp assembly to independently expand the implant proximally or distally or both.

A spinal implant comprises at least one bone fastener including a proximal portion configured for fixation with a first anterior cortical surface of a vertebra and a distal portion configured for fixation with a second cortical surface of the vertebra. The proximal portion is engageable with a surgical driver having a surgical navigation component that generates data for display of an image representing position of the spinal implant relative to the vertebra. The spinal implant can be employed with cervical, thoracic, lumbar and/or sacral regions of a spine. Systems, surgical instruments and methods are disclosed.

The embodiments provide a spinal implant that is configured for midline insertion into a patient's intervertebral disc space. The spinal implant may have a body and the body comprises one or more apertures. The apertures receive fixation elements, such as a screw and the like. The fixation element may comprise one or more anti-backout features, such as a split ring. In addition, at least some of the apertures are designed to permit a predetermined amount of nutation by a fixation element. The apertures that allow nutation enable the fixation element to toggle from one position to another, for example, during subsidence of the implant in situ. Some of the apertures may be configured to rigidly lock with the fixation elements. Moreover, the spinal implant may include features, such as one or more bores, that can accommodate imaging marks to help guide a surgeon.

Techniques and systems for distracting a spinal disc space and supporting adjacent vertebrae are provided. Trial instruments are insertable into the disc space to determine a desired disc space height and to select a corresponding implant. Implants can be also be self-distracting and the implant providing the desired disc space height can be implanted in the spinal disc space.

The present invention provides an expandable fusion device capable of being installed inside an intervertebral disc space to maintain normal disc spacing and restore spinal stability, thereby facilitating an intervertebral fusion. In one embodiment, the fusion device includes a body portion, a first endplate, and a second endplate, the first and second endplates capable of being moved in a direction away from the body portion into an expanded configuration or capable of being moved towards the body portion into an unexpanded configuration. The fusion device is capable of being deployed and installed in both configurations.

An implant includes a first plate and a second plate, a first wedge member and a second wedge member spaced from the first wedge member that couple the first and second plates together. The first and second wedge members configured to translate along the first and second plates from a first contracted configuration into a second expanded configuration. The implant includes an actuation member coupled to the first wedge member and the second wedge member. The actuating member defines a flange extending toward the first and second plates. The actuation member configured to move the first and second wedge members from the first contracted configuration into the second expanded configuration so that the first and second plates separate from each other.

A computer implemented medical method of calibrating a cage is presented. In particular, this calibration method calculates a virtual model of the cage based on a cage tip point and a cage end point, acquired by using a pointer tip of a pointing device, and at least one axis, acquired by using a pointer shaft of the pointing device along a side of the cage. This method allows for providing a more detailed virtual model of the cage, while being in compliance with sterility restrictions.

A vertebral fixation plate assembly for securing adjacent vertebral bodies is provided that is configured to distract or extend along its length, as well as provide multiple degrees of freedom between the fixation points and the vertebral fixation plate in order to accommodate different installation locations, as well as different surgical approaches. Methods of using the vertebral fixation plate assembly are also provided.